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Antipsychotic polypharmacy: review of mechanisms, mortality and management

  • Julie Langan (a1) and Polash Shajahan (a2)

Antipsychotic polypharmacy is an increasingly encountered clinical scenario. This review considers the reasons behind antipsychotic polypharmacy and the patterns of its use. We also consider the evidence of effectiveness of combined therapy v. monotherapy and the rationale behind the potentially beneficial combinations that are used. The potential dangers of antipsychotic polypharmacy are also discussed and the limited research regarding switching from polypharmacy to monotherapy is reviewed. Some provisional recommendations regarding antipsychotic polypharmacy are proposed.

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Polash Shajahan (
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See editorial, pp. 41–43, and original paper, pp. 44–46, this issue.

Declaration of interest

P.S. has received honoraria and hospitality from various pharmaceutical firms including Bristol-Myers Squibb, AstraZeneca, Lilly and Janssen-Cilag.

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BJPsych Bulletin
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